Utyando lwe-Cardiovascular yintsimi enzima efuna ukuchaneka kunye nezixhobo ezithembekileyo zokuqinisekisa iziphumo ezilungileyo zesigulane. Phakathi kwezi zixhobo, i-sutures idlala indima ebalulekileyo ekugcineni intembeko yokulungiswa kotyando, ngakumbi kwiinkqubo ezibuthathaka ezibandakanya imithambo yegazi kunye nentliziyo. Kweli nqaku, siza kuphonononga ezona zixhobo zibalaseleyo zotyando lwentliziyo, sigxile kwiipropathi zabo, izibonelelo, kunye namatyala athile okusetyenziswa ukunceda abaqeqeshi bezonyango benze ukhetho olunolwazi.
Kutheni Ukukhetha Izinto ezifanelekileyo zeSuture Material
Kutyando lwe-cardiovascular, ukukhetha i-suture material efanelekileyo ibalulekile kuba ichaphazela ngokuthe ngqo impumelelo yokusebenza kunye nenkqubo yokuphilisa. Iisutures kufuneka zomelele ngokwaneleyo ukuze zibambe izicubu kunye phantsi koxinzelelo ngelixa zithambile ngokwaneleyo ukuba zingenzi monakalo. Ukongeza, kufuneka babonelele ngeempawu zokuphatha ezibalaseleyo, ukusabela okuncinci kwezicubu, kunye nokhuseleko oluhle lwamaqhina ukuthintela iingxaki.
Izinto eziphezulu zeSuture kwiiNkqubo zeCardiovascular
1.IiPolyester Sutures
I-Polyester yimathiriyeli eyenziweyo, engafunxwanga kwi-suture esetyenziswa kakhulu kuqhaqho lwentliziyo. Inika amandla aphezulu okuqina kunye neempawu zokuphatha ezigqwesileyo, ziyenza ilungele i-vascular anastomosis kunye neenkqubo zokutshintsha ivalvu. I-polyester sutures ithandwa kakhulu ngenxa yokuqina kwayo kunye nokusabela okuncinci kwezicubu, ukunciphisa umngcipheko weempendulo ezivuthayo. Ngokomzekelo, kwi-coronary artery bypass grafting (CABG), i-polyester sutures inceda ukuqinisekisa ukuxhamla okukhuselekileyo kunye nexesha elide phakathi kwe-grafts kunye neenqanawa zomthonyama.
2.Iipolypropylene Sutures
I-Polypropylene lolunye ukhetho oludumileyo lwezicelo ze-cardiovascular, eyaziwa ngokuba bhetyebhetye kunye nokuhambelana kwezinto eziphilayo. Kwakhona yinto engabonakaliyo, enenzuzo kunyango olufuna inkxaso ye-tissue yexesha elide. Umphezulu wayo ogudileyo unciphisa ukwenzakala kwezicubu ngexesha lokudlula, oko kuyenza ilungele ukulungiswa kwemithambo ebuthathaka. Ukunganyangeki kwePolypropylene kusulelo kunye nokuphinda kusebenze kwezicubu ezisezantsi kuyenza ibe yeyona nto ikhethwayo kwiinkqubo ezifana nokulungiswa kwe-aortic aneurysm.
3.I-ePTFE (i-Expanded Polytetrafluoroethylene) IiSutures
Ii-ePTFE sutures zixhathisa kakhulu kwi-deformation, izenza ukuba zibe lolona khetho lubalaseleyo kuxinzelelo oluphezulu lokulungiswa kwentliziyo. Ziluncedo ngakumbi kuqhaqho olubandakanya ukufakelwa kwezinto ezenziweyo, njengoko zibonelela ngokuhambelana kwezicubu kunye nokukhuhlane okuphantsi. Oogqirha badla ngokukhetha i-ePTFE ngokukwazi kwayo ukuphatha i-anastomoses ye-vascular complex ngaphandle kokusika kwiindonga zenqanawa, ngaloo ndlela ikhusela iingxaki emva kokuhlinzwa ezifana nokuphuma kwegazi kwi-suture line.
I-Absorbable vs. I-Non-Absorbable Sutures
Ukuqonda umahluko phakathi kwe-absorbable sutures kunye ne-non-absorbable sutures kubalulekile ekukhetheni izinto ezifanelekileyo kwiinkqubo ze-cardiovascular.
•I-Absorbable Sutures:Ezi sutures ngokuthe ngcembe ziqhekeka emzimbeni kwaye zifunxwa ngokuhamba kwexesha. Ngokuqhelekileyo zisetyenziswa kwiimeko apho inkxaso yenxeba yesikhashana yanele. Nangona kunjalo, kuqhaqho lwe-cardiovascular, sutures absorbable sutures ayixhaphakanga ngenxa yokuba ayiboneleli ngenkxaso esisigxina efunekayo ukulungiswa okubalulekileyo.
•I-Non-Absorbable Sutures:Njengoko igama libonisa, ezi sutures zenzelwe ukuba zihlale emzimbeni ngokusisigxina okanye zide zisuswe. I-sutures engabonakaliyo njenge-polyester, i-polypropylene, kunye ne-ePTFE zikhetho eziqhelekileyo zeenkqubo ze-cardiovascular, ukubonelela ngokuzinza kwexesha elide kunye nokunciphisa umngcipheko wokuhlanjululwa kwe-aneurysmal.
Indima yeSize yeSuture kwi-Cardiovascular Surgery
Ukukhetha ubungakanani obufanelekileyo be-suture kubaluleke ngokulinganayo njengempahla ngokwayo. Kutyando lwe-cardiovascular, i-finer suture sizes (ezifana ne-6-0 okanye i-7-0) zihlala zisetyenziswa ngenxa yokuba zinciphisa ukuxhatshazwa kwezicubu kunye nokuphucula ukuchaneka, ngakumbi kwizakhiwo ezibuthathaka ze-vascular. Nangona kunjalo, ubungakanani obukhulu bunokusetyenziswa kwiindawo ezifuna amandla ongezelelweyo kunye nenkxaso, njengokulungiswa kwe-aortic.
I-Case Study: Impumelelo kwi-Coronary Artery Bypass Grafting (CABG)
Uphononongo olubandakanya izigulane ze-CABG lubonise ukusebenza kwe-polyester sutures ekufezekiseni ukufakelwa okuyimpumelelo. Oogqirha botyando baqaphele ukuba ukomelela okuphezulu kwepolyester kunye nokusabela kwezicubu ezincinci kube negalelo kumazinga asezantsi eengxaki zasemva kotyando kunye nokuphuculwa kokugxunyekwa kwepatency. Obu bungqina bubonisa ukufaneleka kwezinto kwiinkqubo ezibalulekileyo ze-cardiovascular apho i-sutures ehlala ixesha elide kunye nethembekileyo ibalulekile.
Iingcebiso zokuGcina Ingqibelelo yeSuture
Ukuphathwa ngokufanelekileyo kwe-sutures ngexesha lotyando kunokuchaphazela kakhulu iziphumo. Oogqirha botyando bafanele bakuphephe ukuxinezeleka okugqithisileyo xa bebopha amaqhina, njengoko oku kunokukhokelela kumonakalo wezicubu okanye ukwaphuka komthungo. Ukongezelela, ukuqinisekisa ukuphathwa okuncinci kunye nokusebenzisa iindlela ezifanelekileyo zokubopha amaqhina kunokuncedisa ukugcina ingqibelelo yesakhiwo se-sutures, ukuphucula ukusebenza kwabo ngexesha lokuphilisa.
Ikamva lezinto zeSuture kwi-Cardiovascular Surgery
Inkqubela phambili kwi-teknoloji ye-suture ihlala iguquka, igxininise ekuphuculeni ukhuseleko lwesigulane kunye nokuphucula iziphumo zotyando. Izinto ezintsha ezifana neengubo zokulwa ne-antibacterial kunye ne-bioactive sutures ezikhuthaza ukuphilisa ngoku zijongwa kwizicelo ze-cardiovascular. Olu phuhliso lujolise ekunciphiseni amazinga osulelo kunye nokukhuthaza indibaniselwano engcono kunye nethishu, enikezela ngamathuba anomdla kwikamva lotyando lwentliziyo.
Ukukhetha imathiriyeli ye-suture efanelekileyo yotyando lwentliziyo sisigqibo esibalulekileyo esinokuchaphazela kakhulu iziphumo zesigulane. Izinto ezifana ne-polyester, i-polypropylene, kunye ne-ePTFE zinika amandla abalaseleyo, ukuqina, kunye nokusabela kwezicubu ezincinci, zizenza zilungele iinkqubo ezintsonkothileyo zentliziyo. Ngokuqonda iimpawu ezikhethekileyo zezi sutures kunye nokuqwalasela izinto ezifana nobukhulu be-suture kunye nobuchule bokuphatha, oogqirha banokwenza ukhetho olunolwazi oluphucula impumelelo yotyando kunye nokukhuthaza ukuphilisa okungcono.
Kubasebenzi bezempilo abafuna ukuphucula iindlela zabo zotyando kunye neziphumo, ixesha lokutyala imali ekukhetheni imathiriyeli ye-suture efanelekileyo ibalulekile. Ingaba ujongene nokulungiswa kwesiqhelo okanye ukulungiswa kwe-vascular reconstruction, i-suture efanelekileyo inokwenza umehluko.
Ixesha lokuposa: Nov-08-2024
